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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Pediatric endoscopic dacryocystorhinostomy

Chris E de Souza1, Jayesh Nisar, Rosemarie A de Souza

  • 1Lilavati Hospital, Holy Family Hospital and Tata Memorial Hospital, Mumbai, India. chris.desouza1@gmail.com

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|May 5, 2012
PubMed

Insights

Endoscopic dacryocystorhinostomy by removing the medial wall of the lacrimal sac (LS) is effective for treating chronic epiphora in children. This procedure showed a high success rate in resolving symptoms and preventing dacryocystitis attacks.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery

Background:

  • Chronic epiphora and dacryocystitis in children can significantly impact quality of life.
  • Endoscopic dacryocystorhinostomy (DCR) is a surgical option for these conditions.

Purpose of the Study:

  • To evaluate the efficacy of endoscopic dacryocystorhinostomy, specifically removal of the medial wall of the lacrimal sac (RMW of LS), in treating pediatric epiphora.
  • To assess the success rates and outcomes of this surgical technique.

Main Methods:

  • A case series involving a chart review of 37 children who underwent RMW of the LS between 1997 and 2010.
  • Two additional patients with external fistulae and cicatrized lacrimal sacs (LS) received lacrimal stents.

Main Results:

  • 95% of children (37) underwent RMW of the LS, with 92% achieving successful outcomes (patent neofistula) after 12 weeks.
  • 8% of neofistulae required revision due to obstruction within 2 weeks.
  • Stenting for patients with fistulae and cicatrized LS provided temporary relief, with epiphora returning after stent removal.

Conclusions:

  • Removal of the medial wall of the lacrimal sac via endoscopic dacryocystorhinostomy is an effective treatment for chronic epiphora in children.
  • The procedure demonstrates a high success rate in achieving long-term symptom resolution.

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